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HEALTH AND NUTRITION IN BOSSEMPTÉLÉ

“Health and Nutrition for the Vulnerable Population of the Sub-Prefecture of Bossemptélé’ has been a project that we have told you about many times, recounting all the milestones that we have gradually achieved. The project, part of the ‘Emergency Initiative to Support the Vulnerable Population in the Central African Republic’, was funded by the Italian Agency for Development Cooperation (AICS) and started in September 2021.

The interventions were concentrated in Bossemptélé, the town where the John Paul II Hospital – the health hub of the entire region – is located, and in the surrounding 75 km. We are in the Central African Republic, an endemically poor country, where many of the basic services are the preserve of a few, while the majority of the population suffers from precarious and insecure conditions, both health and food. For some years now, moreover, rebel groups have been making the country even more unstable, carrying out violent acts and frightening the already hard-pressed population.

Anche noi di Salute e Sviluppo – nel corso di questo progetto – abbiamo dovuto affrontare questa situazione, che ha rallentato i lavori, rendendoli più difficili e pericolosi. Despite this, we were able to achieve most of the goals we had set ourselves, including the construction of an emergency room for the John Paul II Hospital. Before our intervention, the hospital did not have the possibility to accommodate the most serious patients in a suitable room, now the emergency room has been completed, both in terms of structural construction and equipment. During this year in which construction work proceeded, the hospital was nevertheless able to see more than 9,000 patients, of whom about one third were admitted to receive the right treatment.

Another deficiency we had identified at an early stage concerned the hospital’s ability to guarantee the necessary meals for in-patients: most of those arriving at the facility have a severe state of malnutrition and need to re-establish a proper diet. In the course of this project, we built a kitchen adjacent to the hospital premises, which can offer three meals a day to all patients. Despite the fact that the structural work has only just been completed, a temporary kitchen has been set up since the start of the project, which has managed to provide three full meals a day for more than 1600 patients.

In order to increase the capacity of the John Paul II Hospital to adequately meet the local population’s demand for care, we decided to start a training programme for health personnel. Thanks to this initiative, 38 workers specialised in obstetrics, ophthalmology, laboratory techniques and maintenance of medical equipment were trained.

In order to provide widespread access to care also in the rural areas surrounding Bossemptélé, we rehabilitated, and in some cases built from scratch, the postes de santé located in some villages within the sub-prefecture. Before our arrival, these facilities were unsafe, with severe structural problems and without any furniture or machinery useful for first aid. During the year, we renovated, furnished and equipped the poste de santé of Gbawi (40 km from Bossemptélé), Bodangui, (10 km), and Bombalou (45 km) with sanitary materials, and we built a new poste de santé in the village of Yangoro, 15 km from Bossemptélé. In addition, we have trained more than 30 workers who will ensure an efficient health service by manning these postes de santé. In addition to each of these facilities, a well was also rehabilitated or constructed to provide drinking water, not only to the poste de santé, but also to the entire population of the corresponding village. Thanks to some budget balances, we were able to rehabilitate an additional well in the village of Boyaram. In total, more than 21,000 inhabitants have access to drinking water.

In addition to these villages, there are many others that, not having a poste de santé and being far from Bossemptélé, remain uncovered in terms of health. To solve this problem, we activated and strengthened the mobile clinic service, which – during the course of the project – was able to visit more than 27 villages, providing first aid to the local population. The mobile clinic also started awareness-raising meetings focusing on different health topics, and managed to involve more than a thousand people. In recent months, the climate of instability in the country has worsened: armed rebel groups have targeted large areas, including part of the area where the mobile clinic operates, some of which have been forced to flee. Due to this situation, it was not possible to visit many villages and proceed with all the previously planned activities.

Despite these difficulties, which caused several slowdowns, the project recorded positive results: 14% more of the local population had access to health services, 25% more had access to drinking waterwhile malnutrition dropped from 40 to 38 per cent. The facilities we have built and the activities we have initiated will continue to be a valuable aid for the locals, who will finally have access to adequate health services of a higher standard.

This article was produced within the framework of the project Health and Nutrition for the Vulnerable Population of the Subprefecture of Bossemptélé AID 05/RCA/12049/2021 funded by the Italian Development Cooperation Agency. The contents of this publication are the sole responsibility of the author and do not necessarily represent the views of the Italian Development Cooperation Agency. The Italian Development Cooperation Agency is not responsible for information that is considered erroneous, incomplete, inadequate, defamatory or in any way reprehensible.

CURES AND TEACHINGS IN THE OHUAM PENDÉ

The site of most of the projects we have underway is the Ouham – Pendé region: about 400 kilometres from the capital Bangui, it is one of the poorest areas of the already destitute Central African Republic. The political instability of the entire nation, and the resulting violence, makes poverty endemic and basic rights inaccessible.

Our point of reference in the region is the John Paul II Camillian Hospital in Bossemptélé, which has been working with courage and determination for more than 20 years, representing a landmark for the population who can count on adequate care thanks to this hospital.

The SENÌ- Health and Hygienic Concepts for the Bossemptélé Community project, funded by FONDATION ASSISTANCE INTERNATIONALE (FAI), started on 1 January 2021 with the aim of building the necessary infrastructure for the hospital, supplying medicines and sanitary consumables, recruiting health personnel and promoting hygiene and health education for the local population.

Specifically, as far as infrastructure is concerned, the project aims to contribute to the improvement of the hospital by building a new well that can meet the hospital’s entire water needs and by installing new photovoltaic panels that can guarantee a stable supply of electricity. The well has been completed, is functional and can fully fulfil its function. The panels have all been installed and made operational.

The infrastructural result has been achieved, while the result focused on raising the awareness of the local population on health and prevention issues is ongoing with excellent results. The project includes a series of weekly meetings on specific topics such as nutrition, vitamins, tobacco, alcohol, personal hygiene, malaria vaccination and environmental hygiene. Meetings have already started and continue to take place regularly, both within the hospital and in the surrounding rural areas thanks to the mobile clinic team. To date, more than 4000 people have been involved in awareness-raising activities.

Although the end of the project is set for next summer, the many local actors involved – the Ministry of Health, Ministry of Higher Education, Association pour les Œuvres Médicales des Eglises en Centrafrique – ASSOMESCA and the Order of the Carmelite Sisters of Bossemptélé, as well as the Camillian delegation in the Central African Republic that runs the John Paul II Hospital in Bossemptélé – will continue to work to ensure that the mission of raising awareness among the local population is ongoing and can produce long-term benefits.
We will keep you updated on the progress of the project and the many good stories coming from the John Paul II Hospital in Bossemptélé.

FIRST AID, MEDICAL AND NUTRITIONAL ASSISTANCE: PROGRESS AT BOSSEMPTÉLÉ

The Health and Nutrition Project for the Vulnerable Population of the Sub-Prefecture of Bossemptélé is part of the ‘Emergency Initiative to Support the Vulnerable Population in Central African Republic’ funded by the Italian Agency for Development Cooperation (AICS).

We get to know Bossemptélé better thanks to the numerous projects with which Salute e Sviluppo has been trying to improve the socio-sanitary status of the Central African sub-prefecture for more than 10 years now. The John Paul II Hospital is the symbol of the Camillian commitment in the area: for years it has been responsible for improving the sanitary conditions of the population, remaining a pillar of reference for local communities even when the upheavals inside the country have made complex the activities of many other structures.

Also for this project ses starts from the John Paul II Hospital: despite the improvements made with the previous interventions, still significant are the shortcomings found, first of all the lack of an emergency room. The only room used for initial reception is simultaneously used for outpatient visits. Hence the need to renew the structure to allow the proper division of the premises and the separation between services dedicated to ordinary consultation and the treatment of emergency patients. At the moment the works of the new reception area have reached 32% of construction,the old walls of the structure have been demolished and new ones are being erected.

Most patients arrive at the hospital in a state of severe malnutrition: clearly the lack of food is a serious problem that must be solved, but it is even more effective in patients who have to undergo therapy and who, in the absence of food, cannot take their medication properly. Very often hospital inmates come from neighboring villages and once in Bossemptélé can not afford to buy any basic necessities because of the higher prices of the city than the rural areas to which they belong.

To improve the nutritional conditions of patients, it was decided to build a kitchen adjacent to the hospital with the intention of providing daily at least two meals a day for each patient. In 5 months from the beginning of the project the structure was completed for 80%. Since last December, and until the construction of the kitchen is underway, meals are prepared in a temporary outdoor room. Up to now, more than 3000 patients and relatives of hospital patients have already been served, thus representing a great result for their general health.

 

Another deficiency at the John Paul II Hospital in Bossemptélé, which the project aims to remedy, is that the hospital’s medical staff are not sufficiently trained in certain specialist areas of medicine, including maternity and ophthalmology. Therefore, training courses by specialists from the capital Bangui were set up to make the staff more competent in providing specific care. Classes started in December and continue to take place with the participation of 38 health workers from the hospital.

The projects aimed at improving health and hygiene conditions are not only concentrated in the John Paul II hospital in Bossemptélé, which is indeed the most solid health centre, but are also spread throughout the neighbouring areas with specific solutions that allow the populations of the nearby villages to benefit from many treatments without having to make the journey to the hospital, which is far from easy.

In some villages there are so-called postes de santé, buildings that act as small medical centres, but which need to be upgraded and expanded in order to be operational. Thanks to the project, the renovation of the postes de santé in the villages of Gbawi, Bodangui and Bombalou has started and is now 38% complete. While in the village of Yangoro, the complete construction of a poste de santé is proceeding, now at about 45 % completion. In addition, for the correct compliance with hygiene rules – sanitary each of these principals needs a well in the immediate vicinity that ensures the supply of clean water. For this reason, hand-dug wells have been constructed in all the villages mentioned and are currently being tested.

In order to further expand the offer of adequate medical care, the mobile clinic service has been strengthened, responding to a need that had long been identified in the area of intervention. Rural and poorly connected areas, also without postes de santé, are reached on a rotating basis twice a week (Wednesdays and Saturdays) by hospital staff who perform consultations for all the villagers reached. The mobile clinic is fully functional, operating in territories deemed safe and bringing real benefit to the population. Its sole purpose is not to visit the population, but to be an integral part of a preventive action of education, information and communication on health and hygiene in rural communities. Very often common diseases can be easily avoided thanks to a greater knowledge and awareness of issues and behaviors related to hygiene and health, without resorting to popular practices and beliefs that continue to play a preponderant role in the life of the locals. In fact, the work of traditionally accredited carers/healers, using non-medical techniques, sometimes leads to serious complications and a marked deterioration in the health status of patients.

In order to prevent these practices, which are unfortunately still widespread, and to encourage correct referral to the hospital in case of need, monthly training sessions are held in the hospital meeting room on the last Saturday of each month to raise awareness of the issue among health workers in the postes de santé located in the villages and among the traditional healers themselves, with whom cooperation is increasingly intensifying.

The Health and Nutrition Project for the Vulnerable Population of the Sub-Prefecture of Bossemptélé is now halfway through its journey. Started at the end of September last year, the one-year project is proceeding as planned and is already bringing benefits to the local communities involved.

A hoped-for result, but not a foregone conclusion given the endemic difficulties of the area: both from the point of view of local security, which sometimes undermines the possibility of considerable and lasting results, and because of the poverty of the nation, which is still one of the poorest in the world.

Salute e Sviluppo, together with AICS, aims to bring this project to fruition and contribute to the real improvement of the living conditions of the local population, which continues to be afflicted by diseases that are easily treatable with the right means and the correct prevention. We will keep you updated on further developments and on all the small and large steps that will be taken in the interests of the Bossemptélé sub-prefecture.

 

CENTRAL AFRICAN REPUBLIC: GROWING COMMITMENT TO HEALTH AND NUTRITION

Thanks to the initiative “Health and Nutrition for the vulnerable population of the Sub-prefecture of Bossemptélé“, funded by the Italian Agency for Development Cooperation (AICS)continues the commitment of Salute e Sviluppo to increase access to basic essential services in the Central African Republic. The project, launched on 27 September 2021, is in continuity with previous emergency initiatives in support of the population of Bossemptélé, with the aim of ensuring access to health, food and water for vulnerable groups.

The Central African Republic (CAR) is one of the poorest countries in the world. The serious humanitarian crisis that has affected the country for years continues to have dramatic repercussions on the living conditions of the population.

At the health level, the country is in a chronic state of emergency due to the lack of adequate drugs and equipment and the lack of qualified and specialized personnel. Health facilities outside the capital are almost non-existent and recent clashes between rebel forces and government militias have severely limited their ability to provide care, particularly to women and children.

In the Bossemptélé prefecture, the rate of access to health services is only 45%. The Saint John Paul II Hospital is the only hospital in the city. Patients (including urgent cases) are received in a small, single room where consultations are also carried out. The space for first aid is definitely inadequate and insufficiently equipped. Only in five villages are there poste de santé, first level facilities located in remote and peripheral areas, in which “securiste” (nurses who have no qualifications) work, and which operate mainly on a community basis. They are in a precarious condition, consisting of one or two small rooms, with roofs and walls full of cracks and large openings that cause flooding in case of rain, where people give birth on the floor in the absence of beds and chairs. Most of them are unfurnished, lacking consumables and medical equipment. Some are used as a night shelter when not on duty.

In this fragile context, the project aims to strengthen the health and nutritional care of local communities, increasing the availability, quality and coverage of the services offered in hospitals and villages and ensuring access to food and water.

What the project will actually do for the benefit of about 25,000 people in the intervention area will act on two interconnected levels.

In the Hospital is planned to:

  • Rehabilitate the first reception room and consultations
  • Provide medicines and consumables
  • Organise training sessions for health personnel
  • Build and equip a room for food preparation
  • Distribute daily meals to patients

In the villages is planned to:

  • Rehabilitate three dispensaries and build a new poste de santé
  • Training the poste de santé operators
  • Strengthening the mobile clinic and information education and communication (IEC) service on hygiene and nutrition

The project will run for one year. We will keep you updated soon on the progress of the activities and its results that we will achieve!

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